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15 - Emergency caesareansection

from Section 3 - Intrapartum Emergencies

Published online by Cambridge University Press:  05 November 2012

By
Chitra Ramanathan  and
Leonie Penna
Edited by
Edwin Chandraharan  and
Sabaratnam Arulkumaran
Edwin Chandraharan
Affiliation:
St George’s University of London
Sabaratnam Arulkumaran
Affiliation:
St George’s University of London
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Summary

Depending on the urgency, caesarean sections (CS) are categorised as: grade 1, grade 2, grade 3 and grade 4. Grades 1-3 are all types of emergency CS with differing degrees of urgency. Regional anaesthesia is appropriate for the majority of cases but general anaesthesia may be needed in a grade 1 CS. Lower segment transverse incision is the commonest incision used and is associated with the lowest intra-operative haemorrhage as the lower segment is thin at this level. Classical incision is a rarely used vertical incision in the upper segment of the uterus. Vicryl no.1 on a blunt needle for uterine closure and Vicryl no.1 on a sharp needle for rectus sheath are commonly used sutures. Manual separation of the placenta before spontaneous separation increases the blood loss during CS and also the risk of postoperative endometritis.

Keywords

antihypersensitiveseclampsiafluid managementseizurepreeclampsiapostpartum haemorrhagemagnesium sulphate therapy
Type
Chapter
Information
Obstetric and Intrapartum Emergencies
A Practical Guide to Management
 , pp. 107 - 114
Publisher: Cambridge University Press
Print publication year: 2012

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